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L-citrulline with HIIT alters specific microRNAs in obese older adultsHow 12 Weeks of Hard Exercise Changes the Molecular Machinery of Aging Muscle

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Key Takeaway
Consider microRNA changes with L-citrulline and HIIT exploratory in obese older adults.

This secondary exploratory analysis of a double-blind randomized trial involved 68 obese older adults (36 women and 32 men, mean age 67.2 ± 5.2 years). Participants underwent a 12-week high-intensity interval training (HIIT) program, with 37 receiving L-citrulline (CIT) oral supplementation and 31 receiving placebo. The primary outcome was expression levels of microRNAs in vastus lateralis muscle biopsies and serum, with secondary outcomes including body composition, functional capacities, and muscle health.

Main results showed that expression of myo-microRNAs (miR-133a, b, -1, -206) and muscle-related-microRNAs (miR-499, -208) was not altered following HIIT with or without CIT. However, muscle miR-504-5p level decreased in the HIIT-CIT group (r = -0.6, p = 0.022), and muscle miR-744-5p expression increased in dynapenic participants (r = 0.50, p = 0.04). In men, muscle miR-151a-3p showed downregulation (r = 0.57, p = 0.01), while in women, serum miR-151a-3p showed upregulation (p = 0.01). Serum miR-4433b-5p (p = 0.001) and miR-106b-5p (p = 0.05) showed downregulation.

Safety and tolerability data were not reported. Key limitations include that this was a secondary exploratory analysis and miRNome analysis was performed in participant subsets (n=13). The study reports associations between microRNA changes and clinico-biological parameters, avoiding causal claims. Practice relevance was not reported, and these findings should be interpreted with caution due to the exploratory design and small sample sizes for specific analyses.

The Problem With Aging Muscle

As people age, muscle mass and strength tend to decline in a process called sarcopenia (age-related muscle loss). When excess body fat combines with this muscle weakness, the health consequences can be serious — reduced mobility, higher risk of falls, worsened diabetes control, and faster physical decline overall.

Exercise is one of the best-known tools to fight this, but the results are uneven. Two people can follow the same training program and get very different outcomes. For years, scientists have suspected molecular differences between individuals are part of the explanation — and microRNAs may be a key piece of that puzzle.

What We Used to Think About Exercise Response

The traditional view was straightforward: exercise builds muscle because it creates physical stress, which triggers repair and growth. The molecular details were largely treated as a black box.

But here's the twist: researchers now know that microRNAs — tiny molecules that act as volume knobs on gene activity — play a crucial role in translating that physical stress into biological change. This study is one of the first to map exactly which microRNAs shift in response to high-intensity interval training (HIIT) in older, obese adults.

What microRNAs Actually Do

Think of genes as a library of instruction books for your body. MicroRNAs are like a librarian who decides which books stay on the shelf and which get used. They don't change the instructions themselves, but they control how loudly each gene "speaks" inside a cell.

When a microRNA changes its activity level after exercise, it can dial up muscle repair, dial down fat storage, or adjust how sensitive cells are to insulin (the hormone that controls blood sugar). Understanding exactly which microRNAs shift — and what they control — could eventually allow doctors to predict who will benefit most from a given exercise program, and why.

The Study Design

Sixty-eight obese older adults (average age 67) participated in a 12-week HIIT program. Half were randomly assigned to take a daily supplement of L-citrulline — an amino acid found naturally in watermelon that supports blood flow and muscle function. The other half took a placebo. Muscle biopsies and blood samples were taken before and after the program to measure microRNA levels.

What Changed — and What Didn't

Standard muscle microRNAs — the ones most directly tied to muscle building — did not change significantly with HIIT in this population. That was unexpected. But a different group of microRNAs did shift, and those changes correlated with real improvements in body composition, physical function, and metabolic health.

Participants who took L-citrulline showed a specific decrease in a microRNA called miR-504-5p in their muscle tissue. Lower levels of this microRNA were linked to lower body fat, better physical performance, and higher levels of IGF-1 (a hormone that supports muscle growth). In plain terms: the supplement appeared to amplify a molecular signal that exercise was already trying to send.

This research is exploratory — it identifies associations, not proven cause-and-effect pathways.

What Scientists Didn't Expect

One of the more surprising findings involved a subgroup of participants classified as "dynapenic" — meaning they had low muscle strength despite not being severely underweight. In this group, a microRNA called miR-744-5p increased significantly after training. Higher levels of this microRNA tracked directly with gains in lean muscle mass. This suggests that certain molecular responses to exercise may be uniquely activated in people who need them most.

In men, a different microRNA — miR-151a-3p — decreased in muscle tissue after training, and this drop was linked to better insulin sensitivity. In women, the same microRNA increased in the bloodstream, and that rise correlated with improved muscle power. Same molecule, different direction, different sex — a reminder that biology is rarely one-size-fits-all.

Where This Fits in the Bigger Picture

Exercise science has long struggled to explain the wide variation in how people respond to training programs. These findings suggest that microRNAs circulating in the blood could eventually serve as simple, measurable signals — blood test markers — that help clinicians understand whether a patient is getting the molecular benefits of their exercise program. If certain microRNAs aren't shifting the way they should, that might signal a need to adjust the program, add nutritional support, or investigate other barriers to response.

If you are an older adult managing weight, metabolic health, or muscle weakness, this research supports what many specialists already recommend: high-intensity interval training can produce real physiological benefits even in your 60s and 70s. L-citrulline supplementation is inexpensive and widely available, but it is not proven as a clinical treatment — talk to your doctor before adding any new supplement, especially if you take medications or have kidney concerns.

This was a secondary analysis of a larger trial, meaning the microRNA findings were exploratory, not the original primary outcome. The muscle biopsy substudy included only 13 participants, which limits how much can be concluded from the most detailed molecular data. The study included only adults classified as obese, so results may not apply to lean older individuals or those with very different fitness levels.

The next step is larger, prospective trials that use microRNA levels as primary outcome measures — testing whether specific molecular targets can predict, guide, or optimize exercise prescriptions for older adults. Researchers are also exploring whether monitoring circulating microRNAs in blood — a simple, non-invasive process — could eventually replace the need for muscle biopsies in tracking exercise response. If validated, this kind of molecular monitoring could transform how clinicians support aging patients in staying strong, mobile, and metabolically healthy.

Study Details

Study typeRct
Sample sizen = 68
EvidenceLevel 2
Follow-up2.8 mo
PublishedApr 2026
View Original Abstract ↓
BACKGROUND: High-intensity interval training (HIIT) with or without L-citrulline (CIT) oral supplementation improves body composition, functional capacities and muscle health in obese older adults, potentially through microRNA-driven regulation. We aimed to (1) investigate the impact of a 12-week HIIT on the expression level of microRNAs in vastus lateralis muscle biopsies and serum of obese older adults and (2) assess whether the differential expression level of microRNAs was associated with clinico-biological adaptations to HIIT and provide potential biomarkers of HIIT response. METHODS: In this secondary exploratory analysis of a double-blind randomized trial, 36 women and 32 men (67.2 ± 5.2 years) following 12 weeks HIIT randomized in two groups were supplemented daily with CIT (HIIT-CIT, n = 37) or with placebo (HIIT-PLA, n = 31). Phenotypic variables, serum parameters, muscle biopsies and subcutaneous abdominal adipose tissue outcomes were collected pre-intervention and postintervention. To assess the microRNA profile, the miRNome of muscle biopsy and serum was analysed using next generation sequencing in participants' subsets (n = 13). The microRNAs' differential expression level was analysed pre-intervention and postintervention by TaqMan-real-time qPCR in 68 participants. RESULTS: The expression of myo-microRNAs (miR-133a, b, -1, -206) and muscle-related-microRNAs (miR-499, -208) was not altered following HIIT with or without CIT. In HIIT-PLA, HIIT-CIT and subgroups (based on sex, age, body mass index, dynapenic status), the change in muscle (miR-504-5p, -744-5p, -151a-3p, -106b-5p, -127-5p) and circulating (miR-4433b-5p, 151a-3p, -744-5p, 483-3p, -106b-5p, -484) microRNA levels was associated with changes of clinico-biological parameters. Supplementing HIIT with CIT decreased the muscle miR-504-5p level (p = 0.022), correlating with lower body fat, improved functional capacities, muscle power and increased IGF-1 level (r = -0.6, p < 0.05). MiR-744-5p expression increased in dynapenic participants (p = 0.04), associated with lean mass gain (r = 0.50, p < 0.05), while miR-151a-3p downregulation in men's muscle (p = 0.01) was associated with better insulin sensitivity (HOMA-IR, r = 0.57, p = 0.05). In serum, miR-151a-3p upregulation in women (p = 0.01) correlated with improved muscle power and lower circulating leptin levels, while miR-4433b-5p downregulation (p = 0.001) was linked to reduced fat mass, lean mass gain and enhanced functional capacity. The downregulation of miR-106b-5p (p = 0.05) was associated with a higher adiponectin level and a better score of the 4-m walking test (p = 0.05). CONCLUSION: HIIT did not impact the expression level of myo-microRNAs and muscle-related microRNAs but induced changes in muscle-nonspecific microRNAs in muscle biopsy and serum. Modulations of microRNAs in muscle (miR-504-5p, -744-5p) and serum (miR-151a-3p, -4433b-5p, -106b-5p) were associated with HIIT's beneficial effects, suggesting their role in the HIIT effects and their potential as candidate biomarkers for response.
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